Active NPI
Kim Miller, APN/CNP
- Nurse Practitioner
- Mt Zion, IL
National Provider Identifier
1285638262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209004811
- Practice address
- 1200 N State Highway 121
Mt Zion, IL 62549-1224 - Phone
- (217) 864-5531
- Fax
- (217) 864-2449
- NPI assigned
- Jun 8, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209004811 | IL | Primary |
Addresses
Primary practice location
1200 N State Highway 121
Mt Zion, IL 62549-1224
Mailing address
1200 N State Highway 121
Mt Zion, IL 62549-1224
Phone (217) 864-5531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036068658 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200414000823 | IL | Order and Referring Only - Family Practice | 3779577606 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209004811 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299715200000",
"number": "1285638262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N STATE HIGHWAY 121",
"city": "MT ZION",
"state": "IL",
"postal_code": "625491224",
"telephone_number": "217-864-5531",
"fax_number": "217-864-2449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N STATE HIGHWAY 121",
"city": "MT ZION",
"state": "IL",
"postal_code": "625491224",
"telephone_number": "217-864-5531",
"fax_number": "217-864-2449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KIM",
"credential": "APN/CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-08",
"last_updated": "2011-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209004811",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036068658",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mt Zion, IL
- Michelle Elizabeth Marquis, DPT
- Cassie E Mavis, MS, CCC-SLP
- Maddison Rae Maxedon, APRN
- Stephanie Jo McGeorge, BSN RN CNOR RNFA
- Joseph Thomas Meyers, MSN, APN, FNP-C
- Mount Zion Health and Rehab Center LLC
- Mount Zion Health and Rehab Center LLC
- Mt Zion Unit 3
- Mt. Zion Chiropractic Clinic LLC
- Mt. Zion Hearing Aid Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.